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The Learning Coach: Using Electronic Portfolios to Promote Self-Directed Learning in Residency Melissa Nothnagle, The Learning Coach: Using Electronic Portfolios to Promote Self-Directed Learning in Residency Melissa Nothnagle, MD, Marcia Smith, Ph. D, Paul George, MD Department of Family Medicine Alpert Medical School of Brown University

Learning Objectives • • • Identify strategies for teaching self-directed learning to residents Address Learning Objectives • • • Identify strategies for teaching self-directed learning to residents Address the challenges of self-directed learning in residency programs Describe methods to evaluate self-directed learning in residency

Self Directed Learning • What is self-directed learning? • Also known as self-regulated learning Self Directed Learning • What is self-directed learning? • Also known as self-regulated learning • Active, goal-directed, self-control of behavior, motivation, and cognition for academic tasks (Pintrich)

One model of self-directed learning • A learner-driven process: Evaluate Learning Outcomes Diagnose Learning One model of self-directed learning • A learner-driven process: Evaluate Learning Outcomes Diagnose Learning Needs Select and Implement Learning Strategies Formulate Learning Goals Identify Learning Resources Knowles, 1975

Need for SDL in residency • Learning environment in residency – Lack of learner Need for SDL in residency • Learning environment in residency – Lack of learner control over process – Focus on doing, not reflecting • Heterogeneity of learners – Preparation, study skills, motivation, culture • Foundation for lifelong learning skills

(How) do your residents engage in selfdirected learning? (How) do your residents engage in selfdirected learning?

Learning Coach Model • Guidance needed to develop skills in selfassessment, goal setting and Learning Coach Model • Guidance needed to develop skills in selfassessment, goal setting and reflection • Dedicated time • Trusting and collaborative environment – No evaluation, confidential • One-on-one, to address individual needs of heterogeneous learners Westberg, Jane and Jason, Hillard. Fostering learner’s Reflection and Self Assessment. Family Medicine: 1994; 278 -282.

Meetings with coach • Monthly one-hour meeting • Goal-setting – Monthly goals, long-term goals Meetings with coach • Monthly one-hour meeting • Goal-setting – Monthly goals, long-term goals • Reflections • EBM tutorial – Complementary skill for lifelong learning

Electronic Portfolio Purpose: tool for reflection “My. Folio” program (within E*Value) Imports all evaluation Electronic Portfolio Purpose: tool for reflection “My. Folio” program (within E*Value) Imports all evaluation data Procedure logs Residents may upload presentations & projects • Spaces to record goals and reflections during coaching meetings • • •

Dependent Interested Involved Self Directed Learner Teacher Coach Motivator Facilitator Consultant Adapted from Grow, Dependent Interested Involved Self Directed Learner Teacher Coach Motivator Facilitator Consultant Adapted from Grow, G. Teaching Learners to be self directed. Adult Education Quarterly, Vol. 41, No. 3, pp. 125 -149.

Strategies for success • Funding: HRSA grant • Gradual implementation – First year: program Strategies for success • Funding: HRSA grant • Gradual implementation – First year: program design and getting buy-in – Second year: implementing coaching with one class, electronic portfolios – Third year: expanding to 2 nd and 3 rd year residents • Time carved out of rotations – no outside work required of residents

Our program evaluation • Quantitative – Self-ratings: goal-setting, reflection, ability to manage own learning Our program evaluation • Quantitative – Self-ratings: goal-setting, reflection, ability to manage own learning – Coach ratings after each meeting • Qualitative – Interviews with residents and faculty about learning culture, self-directed learning skills – Portfolio analysis

Coach’s rating form • After each session, coach rates resident’s: – Ability to set Coach’s rating form • After each session, coach rates resident’s: – Ability to set or modify goals – Ability to reflect on own practice • Additional notes recorded: – Quality/quantity of resident reflections – Achievement of short term goals from prior months – Attitude/motivation

Goal-setting ability: Mean scores over time 4. 00 Mean score 3. 50 3. 00 Goal-setting ability: Mean scores over time 4. 00 Mean score 3. 50 3. 00 2. 50 2. 00 1. 50 1. 00 0. 50 0. 00 1 2 3 4 5 Coaching session Generalized linear mixed model to test for linear trend: p<0. 0001

Mean score Reflective ability: Mean scores over time 4. 50 4. 00 3. 50 Mean score Reflective ability: Mean scores over time 4. 50 4. 00 3. 50 3. 00 2. 50 2. 00 1. 50 1. 00 0. 50 0. 00 1 2 3 4 5 Coaching session Generalized linear mixed model to test for linear trend: p<0. 0001

Small Group Discussion • How could you promote self-directed learning among your residents? – Small Group Discussion • How could you promote self-directed learning among your residents? – Goal setting – Reflection on learning

Next steps • Transfer coaching role to advisors in 3 rd year – Residents Next steps • Transfer coaching role to advisors in 3 rd year – Residents comfortable with portfolio, help faculty gain comfort • Qualitative analyses